PATIENTS who have survived early-onset colorectal cancer (CRC) are at higher risk of developing a second cancer in the future, according to data presented at the Digestive Disease Week® (DDW) in Chicago, Illinois, USA. With the increasing incidence rates of early-onset CRC and the number of survivors increasing, there is a need for more knowledge regarding the needs of this group of patients, in order to create better screening and surveillance recommendations.
The team investigated data from the Nation Cancer Institute’s Surveillance, Epidemiology and End Results Program on 7,041 patients diagnosed with early-onset CRC (Stage I–III) between 1992–1999. They identified risk factors for each patient, as well as type of tumour, and treatment. In total, 16.2% of patients developed another cancer, of which 337 were second CRC diagnoses. The 25-year cumulative incidence of subsequent cancer was 16.8% for females and 18.5% for males, while that of second CRC diagnosis was 4.4% in females and 6.4% in males. Furthermore, by the age of 70 years, cumulative incidence for any cancer was 18.4% in females and 19.7% in males, with a cumulative incidence of CRC of 4.5% in females and 6.6% in males. The most common types of subsequent cancers were prostate, breast, lung, and colorectal cancer.
The researchers also noted factors that were associated with an increased risk for cancer. In males, this included higher tumour grade and histology, and lower county-level median household income compared with tumour location and higher stage in females. Author Aniruddha Rathod, Peter O’Donnel Jr School of Public Health at University of Texas Southwestern Medical Center, Dallas, USA, stated that as there are no guidelines available regarding testing for future cancers that are specifically tailored for patients who have survived early-onset CRC: “There may be opportunity to refine screening and surveillance strategies for early-onset CRC survivors given the prevalence of these future cancer types.”
